Acute Adult T Cell Leukemia-Lymphoma (ATL) that Remitted Spontaneously during the Follow-up without Treatment and Survived for a Prolonged Duration

摘要

A 61-year-old man, was born in Sanriku-cho, Iwate and lived in Kanto district for about 40 years. The patient perceived a swelling in the right parotid gland and visited a nearby physician and he underwent blood sampling. As atypical lymphocytes were detected, the patient was referred to our hospital. Peripheral blood smear demonstrated the presence of flower cells. The patient was diagnosed as having acute adult T cell leukemia-lymphoma (ATL). However, the patient declined, to undergo treatment after providing informed consent. Consequently, the patient was followed up in outpatient care. The abnormal lymphocytes and flower cells disappeared from the peripheral blood 4 months after diagnosis and the patient spontaneously remitted or transferred to chronic ATL. The patient was admitted to hospital for the first time 40 months after diagnosis, and ultimately died due to infection. Spontaneous remission of patients with malignant tumor had been reported previously, most of them exhibited hematopoietic malignancy. Cytokines have been strongly speculated to be involved in spontaneous remission.